To the Editor:.—
Benign duodenocolic fistula is infrequent. Most follow carcinoma of the transverse colon. The first fully documented benign case was that of Sanderson in 1963.1 Starzl et al reviewed 24 cases from English, French, and Italian journals. A previous review uncovered an additional 29 cases documented between 1893 and 1967.3 Fully one sixth of all cases have had the point of origin in a duodenal diverticulum.
Report of a Case:—
A 76-year-old white man was hospitalized on May 6, 1966, with bloody diarrhea and syncope. Barium enema examination revealed a fistulous tract extending from the duodenum into a cavity communicating with the transverse colon. A preherniorrhaphy barium enema in September 1965 had revealed only colonic diverticulosis on the left side.The patient was readmitted June 30, 1966, with a temperature of 39.5 C, diarrhea, feculent vomiting, and pain in the abdomen. Blood cultures revealed nonhemolytic streptococcus,